初诊多发性骨髓瘤患者CD28、CD34及CD117的表达水平及临床意义

Expression Levels and Clinical Significances of CD28,CD34 and CD117 in Patients with Newly Diagnosed Multiple Myeloma

目的探究初诊多发性骨髓瘤(MM)患者CD28、CD34、CD117表达水平及与病情、预后的关系。方法选择2014年3月至2018年12月我院收治的101例初诊MM患者纳入研究,收集患者临床资料及预后情况,采用四色流式细胞术检测患者CD28、CD34、CD117表达水平。结果(1)101例MM患者共检出42例(41.58%)CD28阳性,35例(34.65%)CD34阳性,40例(39.60%)CD117阳性;瘤细胞表面CD28、CD117表达与MM患者DS分期、骨质破坏相关(P<0.05),CD28与MM患者β2-MG相关(P<0.05),CD34与β2-MG水平相关(P<0.05)。(2)入组患者随访时间为8~60个月,中位随访时间为32个月,CD28阳性表达组患者生存时间显著短于CD28阴性表达组患者(P<0.05),CD117阳性表达组患者生存率显著高于阴性表达组(P<0.05),CD34表达情况与患者预后情况无相关(P>0.05)。(3)COX多因素分析显示在矫正其他因素后,瘤细胞表面CD28阳性、CD117表达阴性是MM患者预后不良的独立危险因素(P<0.05)。结论CD28、CD117等表面免疫抗原表达情况与初诊MM患者临床症状及预后相关,可作为评估患者病情及预后的参考指标。

Objective To investigate the expression levels of CD28,CD34 and CD117 in patients with newly diagnosed multiple myeloma(MM)and their relationships with the pathogenetic condition and prognosis.Methods 101 patients with newly diagnosed MM admitted to the hospital between March,2014 and December,2018 were enrolled in the study.Their clinical data and prognosis were collected.The expression levels of CD28,CD34 and CD117 were detected by four-color flow cytometry.Results(1)Among the 101 patients with MM,there were 42 CD28 positive patients(41.58%),35 CD34 positive patients(34.65%),and 40 CD117 positive patients(39.60%).The expressions of CD28 and CD117 on the surface of tumor cells were related to DS stage and bone destruction in patients with MM(P<0.05).CD28 was related toβ2-MG in patients with MM(P<0.05),and CD34 was related to the level ofβ2-MG in patients with MM(P<0.05).(2)The follow-up time of the subjects was 8-60 months,and the median follow-up time was 32 months.The survival time of CD28 positive patients was significantly shorter than that of CD28 negative patients(P<0.05).The survival rate of CD117 positive patients was significantly higher than the negative group(P<0.05).The expression of CD34 was not related to the prognosis(P>0.05).(3)COX multivariate analysis showed that after correcting other factors,positive expression of CD28 and positive expression of CD117 on the surface of tumor cells were independent risk factors for poor prognosis of patients with MM(P<0.05).Conclusion The expression of surface immune antigens such as CD28 and CD117 is related to the clinical symptoms and prognosis of patients with newly diagnosed MM.These markers can be used as reference indexes to evaluate patient′s condition and prognosis.